近红外光谱技术监测婴儿麻醉状态下肾氧饱和度的临床意义  

Clinical significance of near-infrared spectroscopy in monitoring renal oxygen saturation in infants under anesthesia

作　　者：姚翠翠[1] 邢大军[1] 谢越涛[1] 马星钢[1] 王常娥[2] YAO Cuicui;XING Dajun;XIE Yuetao;MA Xinggang;WANG Chang’e(Department of Anesthesiology,Shenzhen Children's Hospital,Shenzhen 518038,China;Operating Room,Shenzhen Children's Hospital,Shenzhen 518038,China)

机构地区：[1]深圳市儿童医院麻醉科,广东深圳518038 [2]深圳市儿童医院手术室,广东深圳518038

出　　处：《中国现代医生》2019年第15期106-109,共4页China Modern Doctor

基　　金：广东省深圳市科技计划项目(JCYJ20160429175948904)

摘　　要：目的本研究对儿童麻醉稳定状态与麻醉前静息状态下肾氧饱和度(RrSO2)结果进行比较,旨在评估麻醉对RrSO2的影响。方法选择2016年11月~2017年12月在我院于静吸复合气管插管全身麻醉下行择期手术的1岁以内的患儿35例(其中新生儿10例),应用近红外光谱技术(NIRS)对其进行RrSO2和脑氧饱和度(CrSO2)监测。分别于麻醉前静息状态下及麻醉后心肺功能稳定后10 min内2个时点记录 CrSO2、RrSO2以及脉搏氧饱和度(SPO2)、心率(HR)、平均动脉压(MAP)等血流动力学参数。结果麻醉后心肺功能稳定状态下RrSO2较麻醉前静息状态时稍有下降,但差异无统计学意义(t=-1.226,P>0.05),MAP从麻醉前(56.77±10.32)mmHg 降到麻醉后(53.11±10.00)mmHg,差异有统计学意义(t=-3.413,P<0.01)。RrSO2与CrSO2呈正相关(r=0.57,P=0.00),而与SPO2、MAP、HR无明显相关性(r=0.014、-0.214、0.178,P>0.05)。结论常规气管插管全身麻醉仅可使婴儿MAP在一定生理范围内波动,而对RrSO2无明显影响,不会引起肾脏氧合及灌注下降。Objective To compare the results of renal oxygen saturation(RrSO2) of children under steady state of anesthesia with the results under rest state, in order to evaluate the effect of anesthesia on RrSO2. Methods A total of 35 children(including 10 neonates) who underwent elective surgery under general anesthesia with static intubation combined with tracheal intubation from November 2016 to December 2017 were enrolled. Near-infrared spectroscopy (NIRS)was used to monitor RrSO2 and cerebral oxygen saturation(CrSO2). Hemodynamic parameters such as CrSO2, RrSO2, SPO2, heart rate(HR), and mean arterial pressure(MAP) were recorded at 2 time points in the rest state before anesthesia and in the steady state of cardio-pulmonary function 10 min after anesthesia. Results RrSO2 was slightly decreased in the steady state of cardiopulmonary function after anesthesia compared with that in the rest state before anesthesia, but the difference was not statistically significant(t=-1.226, P>0.05). The MAP was decreased from (56.77±10.32)mmHg before anesthesia to(53.11±10.00) mmHg after anesthesia, and the difference was statistically significant (t=-3.413, P<0.01). RrSO2 was positively correlated with CrSO2(r=0.57, P=0.00), but not significantly correlated with SPO2, MAP and HR(r=0.014,-0.214, 0.178, P>0.05). Conclusion Conventional tracheal intubation under general anesthesia can only cause MAP of infants to fluctuate within a certain physiological range, but has no obvious effect on RrSO2, and will not cause renal oxygenation and perfusion decrease.

关 键 词：近红外光谱技术 脑氧饱和度 麻醉状态 临床意义 肾脏 婴儿 监测 气管插管全身麻醉 

分 类 号：R174[医药卫生—妇幼卫生保健]